“Why am I breaking out at my age?”
I have heard this question from countless clients. The fact is that adult women are actually more than likely to have issues with acne than teenage girls. Why do many women never develop acne problems until their 20s, 30s and beyond? Many factors play a role but the biggest reason is hormonal fluctuations in conjunction with their monthly cycle. Here’s are the 25 facts you need to know about adult acne and how estheticians can help clear & prevent these bothersome blemishes…
~Sheila Milroy, skincare consultant
Characteristics and Causes
1. Genetic predisposition. The predisposition to develop clogged pores and acne lesions is genetic. The inherited genetic tendency for dead skin cells to accumulate inside hair follicles and clog pores causing blemishes. This is important because one’s genetics cannot be changed. Acne can be controlled but not cured.
2. Overproduction of Oil. During part of the menstrual cycle, the female hormones in the bloodstream decrease, resulting in an increase in the concentration of male hormone in the blood. These male hormones know as androgens are the hormonal switch that turn on the oil glands. This overproduction of oil can create clogging and breakouts. The pores become obstructed with solidified oil (sebum) and a buildup or dead skin creating an obstruction in the hair follicles (pores). This entire process creates a perfect environment for acne bacteria.
3. Fewer Comedones. Adult acne generally has fewer open comedones (blackheads), is less pustular and severe, but instead is characterized by mild breakouts that occur frequently and constantly.
4. Chin Acne. Repeat breakouts on a monthly basis are very likely caused by hormone fluctuations. While science does not have a full explanation for this, these flares of blemishes often occur in the lower half of the woman’s face, specifically in the chin and jawline. These blemishes are often very soft and are in the form of a papule.
5. Stress. Stress causes hormonal fluctuations, giving explanation to why stress can also cause flares of acne.
6. Perioral dermatitis. Perioral dermatitis is an acne-like condition that appears as clusters of papules in the mouth and chin area. Its cause is unknown but is believed to be hormonal since it occurs exclusively in females between 20-55 years of age. Perioral dermatitis does not respond to classic topical acne treatment and needs to be referred to a physician for oral antibiotics.
7. Comedogenic makeup. Heavy or comedogenic skin care and makeup products can contribute significantly to pore-clogging and can increase the frequency of acne lesion flares. Look for products that are lightweight and fluid-like in texture that have been independently tested to ensure that they are noncomedogenic. Avoiding ingredients that are known to be comedogenic is a good idea, but real proof of noncomedogenic stats is to have the finish product tested. When our clients come in for a consultation, we encourage them to bring all of their products and makeup to ensure that they are not using something that may be contributing to an acne breakout.
8. Exercising with makeup. Exercising while wearing makeup can worsen acne-prone adult skin. Leave the makeup off while exercising and make sure to thoroughly cleanse the skin after exercising.
9. Inflammatory acne. Some skin care and cosmetic products can cause follicular inflammation that will result in sudden flares of acne. Overnight breakouts of several pimples are often caused by products that are highly stimulating, over-exfoliating, have extreme pHs or even by fragrance.
10. Possible Mystery Contributors There are several out of the box questions we ask our clients in regards to lifestyle that may also have an impact. They are: Do you have pets? Do you play sports that require a helmet? What kind of work do you do? Are you on the phone without a headset where the receiver may touch your chin or jaw areas?
11. Jawline. Excess makeup on the jaw line is easy to miss and tends to catch residue. Fats left on the skin can contribute to clogging and breakouts. Make sure to remove all traces of makeup and cleanser at and just under the jaw line.
12. Acne excoriee. Constant picking at lesions – acne excoriee – not only slows healing, but also causes hyperpigmentation and vascular macules – brown and red spots, and and can lead to scarring.
13. Dairy products and junk food. Certain foods may worsen breakouts tendencies in some people. Dairy products and junk food diets have been implicated. Remember that this does not affect all people. If a client suspects that dairy or any other food causes flare-ups, have the person discontinue that food for six weeks and see if the acne clears up.
Solutions and Recommendations
14. Daily exfoliating gel. Keeping follicles clear is paramount to achieving clear skin. Daily application of an exfoliating gel serum with glycolic acid or salicylic acid, a combination of the two, or a mild 2.5% benzoyl peroxide gel helps to flush the follicles of dead cell buildup, keeping the canal clear and air flowing to help keep acne bacteria in check. The exfoliating product should be applied lightly to all areas, except the eye area, on a daily basis or as directed by your practitioner. Even if the skin has no visible breakout or clogs, using an exfoliating gel will help to flush the follicle canals of debris and microcomedones, which cannot be seen on the skin’s surface.
15. Hydration fluid and sunscreen. Balance any dehydration caused by use of exfoliating gels by regularly applying a tested, noncomedogenic hydration fluid and a lightweight sunscreen.
16. Spot treatments.Spot treatments of individual papules with drying lotions can be helpful in speeding their clearance. Products containing sulfur and resorcinol help to dry up the blemishes and reduce the swelling.
17. Topical treatment. Most chin acne can be controlled with a topical acne treatment. Chronic acne that repeatedly occurs every month and does not respond to topical treatment may have a more serious medical problem causing flares. These clients should be referred to a physician for evaluation and potential hormone therapy.
18. Prescription care. Dermatological treatment of hormonally flared acne may include prescriptions for anti-androgen birth control pills or spironolactone, which also helps control androgen flares.
19. Noncomedogenic products. Daily-use of sunscreen, serums, foundation and even powders need to be noncomedogenic since these products are worn over clog-and-acne-prone areas for prolonged periods of time.
20. Water or Silicon based anti-aging products. Be especially careful when selecting anti-aging products, as they often use fattier bases intended for a lipidic, aging skin. Performance ingredients, such as peptides, alpha hydroxyl acids and antioxidants are not the culprit here, but the vehicle or spreading agent is the frequent offender. Recommend water or silicon based products for aging.
21. Regular cleansing with a foaming cleanser. Controlling oiliness is an important factor in controlling acne. There is a direct correlation between the amount of oil produced by the skin and the severity of an acne condition. The best way to control oiliness is to cleanse the face thoroughly twice a day. A non-fragranced foaming rinseable cleanser will help to remove the excess sebum. In more severe cases, a foaming cleanser that contains benzoyl peroxide may be helpful.
22. Milk emulsion makeup remover. For clients who wear makeup, a thorough cleansing should be performed nightly using a cleansing mild emulsion makeup remover. Rinseable cleansers generally do a less-than-efficient job of makeup removal. After removing makeup with the cleansing milk, the skin may be cleansed a second time with a rinseable foaming cleanser to remove all traces of residue.
23. Deep-cleaning treatments. Deep-cleansing treatments performed at the spa on a regular basis can have a positive effect on clogged pore control. Use of plug-softening deincrustant products and galvanic current, gentle extraction, and a clay and sulfur-based mask may help.
24. Salicylic acid peels. Mild peeling and exfoliation treatments using salicylic acid may help to keep pores free of excess cell buildup. Salicylic acid is lipophilic, which means it is attracted to fat (oiliness). Mild salicylic peels can be performed regularly and are a great way to start a deep-cleansing treatment. There are a great many other exfoliants and treatments that can be very helpful in treating chronic acne.
25. Customized daily regimen. Routine daily home care with the right products is the real key to getting clear and staying clear. It is our job as a skin care professional to find the right program for our client and to educate them on how to properly care for their skin. Our office makes sure to give clear written instructions and keep the regimen as simple as possible. Treatment compliance on the part of the client can make or break success!